Monthly Briefing

February 2016 Monthly Briefing

The Bottom Line

President Obama on February 9 released the final budget proposal of his presidency

Few expect the FY 2017 budget to be approved before the November elections

The President is proposing a 2.6% increase for NIH and a 2.3% reduction for CDC

The CDC Prevention Research Centers are level funded in the President’s proposal

What's New

President Obama Releases FY 2017 Budget Proposal

On February 9, President Obama released the final budget proposal of his presidency. It would provide funding for fiscal year 2017, which begins on October 1, 2016. Few expect Congress to enact regular appropriations measures before the November 8 elections, with one or more continuing resolutions needed until a post-election final bill is enacted. Many of the President’s proposed initiatives and increases would come from “mandatory spending” – spending not subject to appropriations and thus not included in the discretionary spending caps that were included in the October budget agreement. The budget proposal is filled with various other budget gimmicks, reflecting the fact that it is intended to be a political document and not a realistic operating budget. Congress is likely to reject such gimmicks in crafting the final appropriations measure(s).

National Institutes of Health

FY 2017 Request $33.136B (+$825M) (+2.6%)

FY 2016 Enacted $32.311B (+$2.0B) (+6.6%)

FY 2015 Enacted $30.311B

(Program Level Amounts)

The President is proposing a program level increase of $825 million for NIH in FY 2017, but $1.825 billion of the NIH appropriation would come from mandatory spending not subject to appropriations. The President’s proposal includes $680 million for the Cancer Moonshot initiative, $100 million for the Precision Medicine Cohort Initiative, $45 million for the BRAIN initiative, and $165 million for the Environmental influences on Child Health Outcomes (ECHO) program.

NIH estimates that under the President’s proposal, success rates in FY 2017 would be 17.5%, down from the estimated 19.2% success rate in FY 2016. NIH estimates that the proposal would fund 9,946 new and competing research project grants, down 807 RPGs from FY 2016.

Under the proposal, only the National Cancer Institute (+$680M) and the Office of the Director (+$145M) would receive budget increases in FY 2017. The remainder of the NIH institutes and centers would be flat funded.

Within the NIH Office of the Director account, the Administration is proposing a budget of $9.956 million for the Office of Disease Prevention, the same funding it received in FY 2016. The President would also keep the salary cap pegged to Executive Level II.

Centers for Disease Control and Prevention

FY 2017 Request $7.013B (-$165M) (-2.3%)

FY 2016 Enacted $7.178B (+$278M) (+4.0%)

FY 2015 Enacted $6.900B

(Program Level Amounts)

Prevention Research Centers (PRCs): The President is proposing $25.461 million for the Prevention Research Centers, the same amount the program received in FY 2015 and 2016. In its budget justification, the Administration said, “In FY 2017, CDC will continue to support 26 PRCs with the goal of quickly leveraging research findings to build a collection of proven health interventions for use nationwide. The PRCs exemplify how CDC puts science into action, conducting innovative, practical research to improve the health of all Americans.”

Academic Centers for Public Health Preparedness: The Administration did not propose any funds for the preparedness centers in FY 2017. The Administration told Congress, “The FY 2017 budget request reflects the elimination of the Academic Centers for Public Health Preparedness. CDC will continue to support research and training for public health preparedness through the public health preparedness and response research agenda. Eliminating funding for these centers allows CDC to prioritize funding for state and local health departments through the Public Health Emergency Preparedness (PHEP) cooperative agreement.”

NIOSH Education and Research Centers and the NIOSH Agriculture, Forestry, and Fishing: The President’s proposal provides no funds for either set of NIOSH centers. In FY 2016, the Education and Research Centers received $28.5 million in funding and the AFF program received $25 million.

Gun Violence: The Administration is proposing to strike the provision in the annual appropriations bill language which many believe inhibits gun violence research [“None of the funds made available in this title may be used, in whole or in part, to advocate or promote gun control.”] In addition, the Administration is proposing $10 million in new funding for Gun Violence Prevention Research.

Health Resources Services Administration

FY 2017 Request $5.743B (-$454M) (-7.3%)

FY 2016 Enacted $6.197B (+$59M) (+1.0%)

FY 2015 Enacted $6.138B

(Program Level Amounts)

Public Health Training Centers: The President is proposing $17 million for the Public Health Workforce line in FY 2017, compared to the $21 million enacted in FY 2016. Of that amount, the Administration would provide $9.864 million for the Public Health Training Centers, the same amount the program received in FY 2016. The Administration is proposing to consolidate the Preventive Medicine and Integrative Medicine residency programs and to fund them at $7.136 million in FY 2017, down $4 million from last year’s level.

Public Health Traineeships: No funding is recommended for the traineeship program, which has not been funded since FY 2014.

Agency for Healthcare Quality and Research

FY 2016 Request $470M (+42M) (+9.8%)

FY 2016 Enacted $428M (-$15M) (-3.4%)

FY 2015 Enacted $443M

(Program Level Amounts)

AHRQ receives some of its funding from the Patient Centered Outcomes Research Trust Fund. In FY 2017, funding from the Trust Fund is estimated to be $106 million.

Previous Month's Briefings

Congress passed the final fiscal year 2016 appropriations bill on December 18th - 78 days after the start of the fiscal year and after a number of Continuing Resolutions. The advocacy efforts of ASPPH members were very successful. The so-called Omnibus Appropriations Bill provides increases in the appropriation levels for NIH (+6.6%), CDC (+4.1%), and HRSA (+0.6%). Although the bill cuts funding for AHRQ by 8.5%, the agency survived efforts by House appropriators to kill it. ASPPH’s specific program advocacy efforts were also very successful: the CDC Prevention Research Centers were funded at $25.5 million; the CDC Academic Centers for Public Health Preparedness at $8.2 million; the NIOSH Education and Research Centers at $28.5 million; and the NIOSH Agriculture, Forestry and Fishing Centers at $25 million. In another big win, ASPPH was successful in restoring funding to the HRSA Public Health Training Centers to the FY 2015 level. The Senate had cut the program in half.

Congress cleared a Continuing Resolution to fund the Federal Government through December 11, but negotiations on a full year budget agreement have faltered due to House GOP leadership uncertainty. ASPPH’s October policy and advocacy update provides details on the current budget situation as well as on other regulatory and legislative issues of interest of ASPPH’s members.

ASPPH advocates for federal funding for accounts and programs that support public health training and research. In addition, the Association advocates on numerous related policy and regulatory matters. The September public affairs update highlights the current status of the fiscal year 2016 appropriations process, ASPPH’s advocacy coalition activities, and ASPPH’s recent comments on various regulatory proposals and other initiatives.